Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, United States of America.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
PLoS Negl Trop Dis. 2019 Jul 19;13(7):e0007563. doi: 10.1371/journal.pntd.0007563. eCollection 2019 Jul.
Chikungunya virus (CHIKV), an alphavirus that causes fever and severe polyarthralgia, swept through the Americas in 2014 with almost 2 million suspected or confirmed cases reported by April 2016. In this study, we estimate the direct medical costs, cost of lost wages due to absenteeism, and years lived with disability (YLD) associated with the 2014-2015 CHIKV outbreak in the U.S. Virgin Islands (USVI). For this analysis, we used surveillance data from the USVI Department of Health, medical cost data from three public hospitals in USVI, and data from two studies of laboratory-positive cases up to 12 months post illness. On average, employed case-patients missed 9 days of work in the 12 months following their disease onset, which resulted in an estimated cost of $15.5 million. Estimated direct healthcare costs were $2.9 million for the first 2 months and $0.6 million for 3-12 months following the outbreak. The total estimated cost associated with the outbreak ranged from $14.8 to $33.4 million (approximately 1% of gross domestic product), depending on the proportion of the population infected with symptomatic disease, degree of underreporting, and proportion of cases who were employed. The estimated YLDs associated with long-term sequelae from the CHIKV outbreak in the USVI ranged from 599-1,322. These findings highlight the significant economic burden of the recent CHIKV outbreak in the USVI and will aid policy-makers in making informed decisions about prevention and control measures for inevitable, future CHIKV outbreaks.
基孔肯雅热病毒（CHIKV）是一种引起发热和严重多发性关节炎的甲病毒，2014 年在美洲迅速传播，截至 2016 年 4 月，报告了近 200 万例疑似或确诊病例。在这项研究中，我们估计了与 2014-2015 年美国维尔京群岛（USVI）基孔肯雅热病毒爆发相关的直接医疗费用、因旷工导致的工资损失成本以及伤残损失寿命年（YLD）。在这项分析中，我们使用了 USVI 卫生部的监测数据、USVI 三家公立医院的医疗成本数据以及两项实验室阳性病例研究中发病后 12 个月的病例数据。平均而言，发病后 12 个月内，有工作的病例患者平均缺勤 9 天，导致估计损失 1550 万美元。估计直接医疗保健费用在疫情爆发的前 2 个月为 290 万美元，在第 3-12 个月为 60 万美元。与疫情相关的总估计费用在 1480 万至 3340 万美元之间（约占国内生产总值的 1%），取决于感染有症状疾病的人口比例、漏报程度以及有工作的病例比例。USVI 基孔肯雅热病毒爆发相关的长期后遗症估计 YLDs 范围在 599-1322 之间。这些发现强调了美国维尔京群岛最近基孔肯雅热病毒爆发带来的巨大经济负担，并将有助于决策者在制定预防和控制措施方面做出明智决策，以应对不可避免的未来基孔肯雅热病毒爆发。
